Treatment for Women's Health Issues

Women's Health treatment is aimed at females who span through an age range from the early teen years through early adulthood, childbearing, menopause/middle age, and into the "golden" or geriatric years. Women's health issues include pre-natal/post-partum care, pelvic pain, incontinence, pelvic organ prolapse, osteoporosis, endometriosis, fibromyalgia, irritable bowel syndrome, and musculoskeletal injuries to name a few. Listed below you will find conditions that are commonly seen in the female population.

Bladder Disorders: Interstitial cystitis Pelvic floor organ prolapse Urinary incontinence including urgency, frequency, retention

Bowel Disorders: Constipation Diarrhea Fecal incontinence Hemorrhoids IBS (irritable bowel syndrome) Inflammatory bowel disorders Pelvic floor organ prolapse Sexual Dysfunctions: Dyspareunia Endometriosis Lichens Planus Lichens Sclerosus Pelvic Congestion Pelvic Inflammatory Disease (PID) Pelvic Pain Vaginismus Vulvar Vestibulitis Vulvodynia

Musculoskeletal: Orthopedic and Musculoskeletal Conditions ( see common conditions page for detailed listing) Fibromyalgia Osteoporosis

Other Conditions Treated in the Female: Infertility: The inability to conceive after one year of well timed and unprotected sexual intercourse. Physical therapy can help to free soft tissue restrictions and adhesions in order to increase mobility of the reproductive organs. Treatment can also help decrease spasms around the reproductive organs, ease localized pain and related anxiety. Mastectomy: Lack of movement can cause stiffness in the shoulder and pain or swelling in the upper extremity. Physical therapy will assist with increasing range of motion, strength, improving posture and decreasing swelling. Physical therapy can also help to decrease pain in the neck, shoulder, chest and abdomen. Manual techniques will help decrease scar tissue restriction and increase circulation which in turn promotes healing. Hysterectomy: The surgical removal of the uterus. Often performed for conditions such as uterine prolapse, fibroids, carcinoma (cancer), or abnormal vaginal bleeding. A hysterectomy can be carried out vaginally, abdominally, or laparoscopically. Total abdominal hysterectomy is the most common type of hysterectomy. It involves removal of the uterus and cervix (with or without the removal of the ovaries or fallopian tubes) through an abdominal incision. Vaginal hysterectomy is the removal of the uterus and cervix through the vagina. Recovery from a vaginal hysterectomy is of shorter duration than an abdominal hysterectomy. Laparoscopically-assisted vaginal hysterectomy is a vaginal hysterectomy with the insertion of a laparoscope through a small incision in the navel. Laparoscopic supracervical hysterectomy is the removal of the uterus (sparing the cervix) through incisions in the navel and abdomen. This procedure has the shortest recovery time. Sparing of the cervix may have some benefits which reduces the risk of pelvic floor prolapse and urinary incontinence. A complication of hysterectomies is pelvic adhesion or scar tissue that forms within the pelvis and causes organs to adhere to one another. Pelvic adhesions are also seen after other gynecologic surgeries such as cesarean section, laparoscopic surgery used in the treatment of endometriosis, and with pelvic inflammatory disease. Pelvic adhesions may cause pelvic pain, pain during intercourse, and may contribute to infertility and bladder or small bowel obstruction. Physical therapists specially trained in scar tissue mobilization and visceral mobilization are able to decrease scar tissue and adhesion restrictions to aid in increased mobility of the connective tissue, organs and of the muscles. This in turn may decrease symptoms and prevent complications after necessary surgical interventions. Pelvic Floor Organ Prolapse: Cystocele : A cystocele is the herniation or protrusion of the bladder into the vagina most often due to pelvic floor muscle weakness and may result in incomplete emptying of the bladder and consequently urinary leakage. It is graded from mild (grade 1) to severe (grade 3). In a grade 3 prolapse the vaginal wall and bladder may protrude outside of the vagina. A cystocele can be managed with pelvic floor physical therapy which includes strengthening of the pelvic floor muscles. A pessary (ex. Colpexin) may also be prescribed by the referring physician. Surgery is prescribed when physical therapy and/or a pessary are not effective. A cystocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation (increases pressure on the bladder during straining), weight control, and kegels (performed under the supervision of a specially trained physical therapist initially to prevent muscle substitution and incorrect technique). Enterocele : Herniation or protrusion of the small intestine between rectum and vagina. Rectocele: Herniation or protrusion of rectal tissue in the vaginal wall and may sometimes lead to drooping of vaginal tissue out of the vaginal canal. It may occur with childbirth, chronic constipation, chronic coughing, heavy lifting, estrogen deficiency and/or obesity. Symptoms may include constipation and/or pelvic pain. A rectocele may be prevented through correct body mechanics with lifting, avoidance of straining, controlling and treating constipation, weight control, and kegels. A rectocele can be managed with pelvic floor physical therapy and the use of a pessary. Surgery is prescribed when physical therapy and/or a pessary are not effective. Uterine Prolapse Herniation or protrusion of the uterus into the vagina.

Dear Readers, If you have ever had a chronic pain of some sort then you can probably relate to my story. For 10 years now I have had this urgency feeling in my lower abdomen that causes a burning sensation. It started out just hurting a few times a month. Soon it got to be a few times a week. Then it became an everyday nuisance. It didn’t matter whether I was working at the office, running at the park, or trying to enjoy a romantic vacation with my boyfriend, it was always on my mind. I tried talking to my OBGYN about it and she said it was probably just a yeast infection or a bladder infection. I would take the medicine that she would prescribe but it provided no relief. They did a blood test along with a few other tests and found out there was no infection. They said 'everything is normal'. But I knew better... I knew my body was trying to tell me something is wrong. I researched for hours a day on the internet trying to find an answer to my medical mystery. That is when I happened upon the IC network (www.ic-network.com). It was there that I learned there are thousands of women who have this chronic pain in the bladder called Interstitial Cystitis. Unfortunately, not too many doctors focus on this issue as there is still a lot of research going on to find the actual cause of it as well as a cure for it. Soon after I started learning about this mysterious pelvic pain a close friend from college told me about a wonderful Physical Therapist, Mitzi Gibson, with Advanced Physical Therapy. She has a lot of experience with women’s health and she treats patients with the symptoms of IC. From the minute I walked through the door I felt that I was in good hands. Mitzi took the time to listen to me talk through my problems and symptoms. She sympathized with me and let me know that I am not alone. She taught me that there are multiple reasons why I am prone to IC and what I can do to stop it. Not only did her physical therapy and exercises help, but we worked on relaxation techniques in order to release pressure put on the problem areas. I kept a detailed food journal to figure out trigger foods that cause flare ups. Together, Mitzi and I researched the IC Network to find natural remedies that in time will help promote a healthy bladder. The most important thing that Mitzi did was let me know that I can beat this and take control over my body again. I began my therapy with Advanced Physical Therapy in November of 2008. Even after just 2 months of therapy, keeping a food journal, changing my eating habits and taking the natural remedies I can go a few days without having the constant burning and pain. I know it’s a long road ahead but I can fall asleep at night knowing that I have an intelligent, caring and wonderful physical therapist who's just a phone call away! L.N.

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